What is Inferior Turbinate Resection?

Several surgical procedures may be helpful relieving nasal obstruction which is refractory to medical management. Sometimes surgery is indicated primarily with an anatomical abnormality or neoplasm is suspected.

Effects of Inferior Turbinate Resection

The primary advantage of this procedure is addressing both bony and mucosal hypertrophy of the entire length of the turbinate.

Candidates for Inferior Turbinate Resection

Several surgical procedures may be helpful relieving nasal obstruction which is refractory to medical management. Sometimes surgery is indicated primarily with an anatomical abnormality or neoplasm is suspected.

Your Consultation

Several surgical procedures may be helpful relieving nasal obstruction which is refractory to medical management. Sometimes surgery is indicated primarily with an anatomical abnormality or neoplasm is suspected.

The Inferior Turbinate Resection Procedure

Should medical management fail, the clinician has several options. The many types of surgery for inferior turbinate enlargement can be broadly classified into three categories: (1) simple mechanical means, such as crushing or lateral fracturing, (2) destructive procedures, such as electrocautery or laser vaporization, which reduce the volume of the turbinate, and (3) actual resection procedures, such as submucosal resection, partial resection, trimming of the turbinates, or inferior turbinoplasty.

Recovery

If significant bony or mucosal resection is involved, postoperative packing may be placed. Various dissolvable materials that facilitate hemostasis are available. Traditional nonabsorbable sponge packs can also be placed and are usually removed within 24 hours after surgery. Postoperative bleeding can usually be managed with topical decongestants, hemostatic materials such as Surgicel, or nasal packing. Persistent bleeding despite these measures may require a return to the operating room and possibly endoscopy.

Instruct the patient to avoid heavy lifting or strenuous activity for several weeks after surgery (usually 2-3 weeks). Similarly, patients should avoid medications or herbs with anticoagulant effects for a similar period. Nasal saline should be used aggressively to minimize nasal dryness and crusting postoperatively. This should be continued until the mucosa has healed completely. Once this has occurred, adjunctive medical treatments such as topical glucocorticoids can be resumed.

Risks

The inferior turbinates are very vascular structures and one of the risks of surgery is hemorrhage. Patients with coagulopathies are clearly at increased risk of complications. Similarly, patients should not be taking any medications or herbs that affect their coagulation cascade.

Take care when resecting turbinate tissue in patients who have preexisting complaints of nasal dryness and crusting secondary to the concern about atrophic rhinitis.

There is the risk of bleeding and postoperative crusting. Long-term concerns are rhinitis sicca, ozena, and atrophic rhinitis.

FAQs

What is the inferior turbinate?

The inferior turbinate is large and fills the lower portion of the nasal airway. It is a long structure, and extends from the front of the nose to the rear. The turbinate functions to humidify the air, it shrinks and swells to regulate nasal air resistance, and it collects airborne particles on its surface to clean the air.

What causes enlargement of inferior turbinates?

There are two main reasons for enlargement. Most of the time, enlarged inferior turbinates are the result of allergies, irritating environmental exposure, or some minor persistent inflammation within the sinuses. Another reason is deformity of the nasal septum that has caused the bone on the wider side of the turbinate to increase in size. Large, swollen inferior turbinates can lead to blockage of nasal breathing.

What are the possible treatments for inferior turbinates?

In the case of allergy- or irritant-related enlargement, treatment of the underlying problem may reduce turbinate swelling and solve the problem. If not, turbinate reduction surgery may be required. Because the turbinates help the nose to clean and humidify the air we breathe, it is usually better to leave as much tissue intact as possible. The doctor will probably opt for selective, or targeted, turbinate reduction – rather than extensive reduction.

What are the complications in this procedure?

Complications associated with inferior turbinate surgery include bleeding, crusting, dryness, and scarring. If you undergo an inferior turbinate reduction, your doctor may prescribe a spray or watery solution to relieve dryness and aid in healing. There is generally less risk of serious complications today than in the past, when inferior turbinates were extensively cut out, sometimes causing excessive crusting and nasal dysfunction.